Dynamics of Cough Frequency in Adults Undergoing Treatment for Pulmonary Tuberculosis

Proaño, Alvaro; Bravard, Marjory A.; López, José W.; Lee, Gwenyth O.; Bui, David; Datta, Sumona; Comina, Germán; Zimic, Mirko; Coronel, Jorge; Caviedes, Luz; Cabrera, José Luis; Salas, Antonio; Ticona, Eduardo; Vu, Nancy M.; Kirwan, Daniela E.; Loader, Maria-Cristina I.; Friedland, Jon S.; Moore, David; Evans, Carlton A.; Tracey, Brian H.; Gilman, Robert H.

doi:10.1093/cid/cix039

Cited by 58 publications

(57 citation statements)

References 31 publications

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“…One report addressing the effect of pulmonary TB treatment on cough was identified. 50 There was a statistically significant decline in cough frequency after patients had been receiving treatment for 14 days, and there was a further reduction in cough frequency after patients had been receiving treatment for 2 months. 50 Despite expectations to the contrary, we did not find studies that directly addressed whether cough resolves more slowly with effective antimicrobial therapy in patients with pulmonary TB with cavitary lung involvement than in patients with pulmonary TB with noncavitary pulmonary disease.…”

Section: Discussionmentioning

confidence: 88%

“…A recently published subanalysis from a small prospective cohort study from Peru quantified cough in 64 patients who were HIV negative and starting treatment for culture-positive pulmonary TB and reported a significant reduction in cough by day 14 of treatment and a further reduction after 2 months of treatment. 50 A semiautomated ambulatory cough monitor with a demonstrated sensitivity of 77.5% and specificity of 99.3% identified cough episodes in patients with pulmonary TB. The investigators excluded monitor malfunctions and periods of poor sound quality due to high background noise, and two trained nurses listened to validate the portions of the recording tape with identified cough events.…”

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confidence: 99%

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Cough Due to TB and Other Chronic Infections

Ireland¹,

Adams²,

Altman³

et al. 2018

Chest

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On the basis of relatively few studies of fair to good quality, we conclude that most individuals at high risk and household contacts with cough ≥ 2 weeks do not have pulmonary TB, but we suggest screening them regardless of cough duration. In PLWHIV, the addition of the other WHO-endorsed symptoms increases the diagnostic sensitivity of cough. Earlier screening of patients with cough will help diagnose pulmonary TB sooner but will increase the cost of screening. The addition of ACF to PCF will increase the number of pulmonary TB cases identified. Screening asymptomatic individuals is cost-effective only in groups with a very high TB prevalence. Data are insufficient to determine whether cough resolution is delayed in individuals with cavitary lung disease or in those for whom treatment fails because of drug resistance, poor adherence, and/or drug malabsorption compared with results in other individuals with pulmonary TB. Cough is common in patients with lung infections due to MAC, other nontuberculous mycobacteria, fungal diseases, and paragonimiasis.

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Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 99%

Cough Due to TB and Other Chronic Infections

Ireland¹,

Adams²,

Altman³

et al. 2018

Chest

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“…Plasma samples were collected in prospective studies involving adult TB patients in Lima, Peru with a new diagnosis of culture-positive, drug-sensitive pulmonary TB (25). 50 age-and sex-matched healthy controls were asymptomatic and purified protein derivative (PPD)-negative.…”

Section: Methodsmentioning

confidence: 99%

Platelets Regulate Pulmonary Inflammation and Tissue Destruction in Tuberculosis

Fox

Kirwan

Whittington

et al. 2018

Am J Respir Crit Care Med

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“…It is also interesting that there were 6 occasions with high cough frequency (>5× the median cough frequency for the whole cohort) and no aerosolised Mtb detected. Although this could suggest a difference in our study population, in every other respect cough was predicted by the same patient indices (sputum and CXR grade) as the previous studies 12,18,21,22 .…”

Section: Discussionmentioning

confidence: 58%

Twenty-four hour face mask sampling in pulmonary tuberculosis reveals three distinct patterns of bacterial aerosol production dissociated from conventional markers of transmission risk

Williams

Abdulwhhab

Birring

et al. 2018

Preprint

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Rationale: Although tuberculosis (TB) is transmitted by Mycobacterium tuberculosis (Mtb) in aerosols, little is known of the dynamic characteristics of spontaneous output of bacilli in this form. We have developed and implemented a mask aerosol sampling system (MASS) for longitudinal capture and study of spontaneous aerosol.Objective: To determine patterns of Mtb output in aerosols, captured using the MASS over 24 hours and their association with existing criteria used to assess transmission risk in patients with pulmonary TB.Methods: Twenty-four hospitalised patients with newly diagnosed pulmonary TB recruited in Pretoria, South Africa, wore FFP1 masks for one hour out of every three for 24 hours. Aerosol was captured in a gelatine filter processed for Mtb quantitation by PCR. Serial sputum was collected and objective cough frequency monitoring performed over the same period.Measurements and Main Results: Mtb was detected in 86.5% of 192 mask samples and 20.7% of 38 assessable sputum samples obtained from the cohort. Mtb was detected by MASS in all but two patients. Three dynamic patterns of expression were identifiable in Mtb aerosol producers: i. variable high; ii. consistent; and iii. variable low. No diurnal variation was apparent and there was no correlation between mask Mtb and either sputum Mtb levels or cough frequency. Sputum smear status, culture time to positivity and chest radiographic characteristics also failed to associate with MASS bacillary output.Conclusions: Conventional markers of tuberculosis case infectivity do not predict bacillary aerosols detected by the MASS. The MASS provides a novel, non-invasive tool for tuberculosis diagnosis and control.

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Dynamics of Cough Frequency in Adults Undergoing Treatment for Pulmonary Tuberculosis

Cited by 58 publications

References 31 publications

Cough Due to TB and Other Chronic Infections

Cough Due to TB and Other Chronic Infections

Platelets Regulate Pulmonary Inflammation and Tissue Destruction in Tuberculosis

Twenty-four hour face mask sampling in pulmonary tuberculosis reveals three distinct patterns of bacterial aerosol production dissociated from conventional markers of transmission risk

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